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General NPI Number Information
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NPI Number | 1427428077
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Entity Type | Individual
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Provider Name | AUGUSTA SLOCUM FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/25/2015
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Last Update Date | 06/19/2024
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Provider Practice Location Address
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Address Line | 80 PINNACLES DR STE 700
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City | PALM COAST
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State | FL
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Zip | 32164-2915
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Country | US
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Telephone | 386-387-8500
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Fax | 386-387-8511
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Provider Business Mailing Address
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Address Line | 7751 BELFORT PKWY STE 350
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6951
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Country | US
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Telephone | 904-363-2113
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Fax | 904-363-2606
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | APRN11019079
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License Number State | FL
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